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ul—I.8:UU 1,ici LU:4U V.11 b;f: rU TO <br /> �' n1.-�7-2 ti] 1!J 15i IrS FR' Coo tor,Wwacc 1 <br /> CDN 1t7aC3�tlh7 C C)I tR1TVD�ILLI 1f' ----A! T--( 4Ff3vIrFS <br /> -F!Jv!Ro*IMENTAi- H Al T>i MI-510" <br /> 304 FAST WF_RER AVENUE.THIRD FLOOR <br /> STOCiaON CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 4��f('1 C VIL UUSINESS/AGENCY <br /> APPLICANT <br /> enhv,;cc � 77i�) �G>! !f'1/SUAeY� �T, T7✓4�.'�+•1, �rr!?�/!J✓I �-711h <br /> U 7~ FACSIMILE I,� � d rU % <br /> PHOhiE E� <br /> TENTATIVE*APPOLNTME�T DATE 7loq <br /> (7r�su givo 7 i�14 bus ne55 days:,Om date of Opp llallph submittal) FES 3 2000 ee�� <br /> CHECK BOX TO FXPED[TF REOUEST•$78,1?9�FFE--RE UEsT PROCF5SED rN 3 1RUSIKr'gS DAYS <br /> DATE �� <br /> SIGNATURE OF APPLICANT � <br /> FILE ADDRESS <br /> 6 6 15� iq � ¢��,~ez 1 <br /> v it <br /> it <br /> i KIP�c� )/fS �1 <br /> /3 oh ? Now;11y) SII Y�� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑ HOUSING ABATEMENT ❑ SOUA WASTC FACILITY <br /> n LrNDERGROUNt7 TANK(UST)CLEANUP SITE(LOP) Ct FOOD FACILrrY ❑ SOLID WASTE V15HICLE. <br /> ❑ OTHER CLEANUP SITE(NON-LOP) p DOG KENNEL Q DAIRY <br /> © UNDERGROUND TANK(MONITORINWREMOVAL) U CHICKEN(RANCH CI PKG TREATMENT PLANT <br /> U HAZARDOUS WASTE G <br /> ASTLNERATOIR TEL C FU APER TR11CKJYARc`;ICMEGf.T01LET-S <br /> r- TIERED PERMITTED FACILITY El MOTEULiOTELIHO ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOOI ❑ PO <br /> BODY FEIRCING O pugL S WATER SYSTEM <br /> OTHER(PLEASE SPECIFY ABOVE) <br /> 17 MEDICAL WASTE FACILITY <br /> 1. List up to ten addrosses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. F Y t (2091 464-11138 or mall to the <br /> addre- indica d a ove <br /> 2. Elie will notify the applicant if any EHD files exist. An appointment for review will bllc�� Thf�files <br /> approximately five business days but no iater than tcn (10)days after receipt of app <br /> wilt be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingiy- <br /> A file that i.s aci3YCly bcir:g worked on by E1JD staff may not be immediately avai(abie for review. Anew <br /> application may be submitted when the file iS arailabIC. <br /> 4, Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $7B-00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmad with EHD staff. <br /> u, applications received after 3:00 prn will be processed the next business day. <br /> C41r41=1�titEu APPOINTMENT DATE <br /> TIME <br /> DATE CONFIRMED PHONE FAX <br /> INITIALS <br /> REVIEWED YES MO REVIF-W DATE <br /> EN DO Ig aIPasrou <br /> TOTAL P.02 <br />